The NSABP is a multi-institution cooperative group studying the efficacy of various treatment plans for cancers of the breast and bowel. The Kaiser-Permanente Medical Care Program, Portland, Oregon, has been a member of the NSABP for five years, first under a contract and subsequently as a granted institution. Our accrual of patients has steadily increased as the Kaiser Health Plan population has grown and as we have involved more and more surgeons in NSABP activities. Over the next five years, the term of this grant renewal, we expect the number of patients available for study to increase by close to 50% as our Plan membership rises. The basic organization of our group includes the principal investigator, a medical oncologist, who oversees a core team of nurse oncologists, an administrator and a counselor. Patients are quickly identified from nearly automatic referral by surgeons after the initial diagnostic maneuver has been performed. Patients are then interviewed and randomized into the appropriate study. All therapy is carried out at a single central location. Records are filed in the same location, providing both quick access to pertinent information and assurance of excellent follow-up. Over the next five years this basic system will remain intact but will need to expand somewhat as more patients are added to study. The principal investigator is Chairman of the Chemotherapy Committee of the NSABP, and, as such, is frequently involved in Headquarters activities both by phone and on frequent trips to Pittsburgh. He will continue his major involvement with protocol design, toxicity monitoring and general assistance to investigators with management of patients on study.